Trillium Woods
14585 59th Avenue North, Plymouth, MN 55446


Trillium Woods is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 245627. The address is 14585 59th Avenue North, Plymouth, MN 55446. The zip code is 55446. The phone number is 7637449400.


Trillium Woods · 14585 59th Avenue North, Plymouth, MN 55446

Federal Provider Number 245627
Provider Name TRILLIUM WOODS
Address 14585 59TH AVENUE NORTH
PLYMOUTH, MN 55446
Phone Number 7637449400
SSA County Code 260
County Name Hennepin
Ownership Type For profit - Partnership
Certified Beds 44
Certified Beds Residents 30
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name LCS-WESTMINSTER PARTNERSHIP V LLP
Date First Approved to Provide Medicare Medicaid Services 09/30/2015
Continuing Care Retirement Community true
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 5
Health Inspection Rating 5
Quality Measure Rating 3
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 4.995
Reported LPN Staffing Hours per Resident per Day 2.20167
Reported RN Staffing Hours per Resident per Day 0.915
Reported Licensed Staffing Hours per Resident per Day 3.11667
Reported Total Nurse Staffing Hours per Resident per Day 8.11167
Reported Physical Therapist Staffing Hours per Resident Per Day 0.38167
Expected CNA Staffing Hours per Resident per Day 2.46811
Expected LPN Staffing Hours per Resident per Day 0.68086
Expected RN Staffing Hours per Resident per Day 1.02512
Expected Total Nurse Staffing Hours per Resident per Day 4.1741
Adjusted CNA Staffing Hours per Resident per Day 4.96584
Adjusted LPN Staffing Hours per Resident per Day 2.68392
Adjusted RN Staffing Hours per Resident per Day 0.66693
Adjusted Total Nurse Staffing Hours per Resident per Day 7.83339
Cycle 1 Total Number of Health Deficiencies 1
Cycle 1 Number of Standard Health Deficiencies 1
Cycle 1 Health Deficiency Score 4
Cycle 1 Standard Survey Health Date 08/25/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 4
Cycle 2 Standard Health Survey Date 09/30/2015
Total Weighted Health Survey Score 2.4
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Trillium Woods

Owner Name Role Association Date
BRIDGEWATER, DIANE (Individual) DIRECTOR since 04/02/2007
BRIDGEWATER, DIANE (Individual) OFFICER since 04/02/2007
DOHERTY, SCOTT (Individual) DIRECTOR since 09/03/2015
DOHERTY, SCOTT (Individual) OFFICER since 09/03/2015
FETNER, ELIZABETH (Individual) OPERATIONAL/MANAGERIAL CONTROL since 08/01/2016
HAAK, TINA (Individual) MANAGING EMPLOYEE since 08/11/2015
HOLIEN, MORGAN (Individual) OPERATIONAL/MANAGERIAL CONTROL since 10/24/2016
KENNY, EDWARD (Individual) DIRECTOR since 05/19/2006
KENNY, EDWARD (Individual) OFFICER since 05/19/2006
LCS HOLDINGS, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2006
LCS MINNEAPOLIS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
15%
since 07/31/2006
LIFE CARE COMPANIES LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/01/2010
LIFE CARE SERVICES COMMUNITIES, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2006
LIFE CARE SERVICES LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 07/01/2015
MERCURIS PENDROY, ALLISON (Individual) DIRECTOR since 11/05/2014
MERCURIS PENDROY, ALLISON (Individual) OFFICER since 11/05/2014
NELSON, JOEL (Individual) DIRECTOR since 05/19/2006
NELSON, JOEL (Individual) OFFICER since 05/19/2006
WESTMINSTER FUND CCRC INVESTORS LP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/31/2006
WESTMINSTER FUND VII LP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/17/2006
WESTMINSTER-LCS-PLYMOUTH LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/17/2006

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